Poor Circulation

Venous Insufficiency

When evaluating a patient for venous insufficiency, or poor circulation, physicians utilize several methods to examine the patient. Most physicians start with the patient’s history. Next, the physician may perform a physical exam followed by a duplex ultrasound study.

History

General medical and surgical information, as well as specific information about vascular disease

Onset of the problem

Predisposing or aggravating factors of symptoms

Patients are specifically asked about the common symptoms seen with venous insufficiency, such as leg heaviness, aching, itching, pain, fatigue, and swelling

Physical Examination

While a physical examination should not be used as the sole evaluation, there are several physical findings that are associated with venous reflux:

Asymmetry of the limbs (size, length, ankle diameter)

Scars (previous venous surgery or ulcers)

Skin changes

Lower limb swelling (edema)

Skin ulcers

A common physical exam that physicians may use to assess a patient is the Trendelenburg Exam. A physician may also perform a palpation of arterial pulses to confirm that there is not another underlying disease.

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